Abstract: Background: Malaria is a global public health problem; around 44% of the world’s population lives with the risk of the disease. In 2015, there were 198 million malaria cases in the world. The prevalence of malaria varies in space; not only between countries, but also within highly endemic countries, where it is particularly influenced by socioeconomic or environmental factors.
Objective: The objective of this study is to obtain a global view of factors influencing malaria infection in children in Africa.
Methods: A multi-level logistic regression model was used, with the national level being the highest. As a complementary tool, a classification tree provided a visual schema of sub-groups with higher malaria risk. Finally, we used geographically weighted regression (GWR) to assess the spatial heterogeneity of the relationship between the significant community factors and malaria prevalence.
Results: Using multilevel regression, we found that certain factors have a significant association with malaria risk in sub-Saharan countries. At individual level: the age of a child, maternal education level, febrile status, anaemic status and the possession of a bed net for sleeping. At household level: economic status, the availability of electricity in the house and place of residence (i.e. urban or rural). At community level: quantity of precipitation, population density and conflict events. Globally, we found a positive relationship between malaria risk and both population density and quantity of precipitation. However, geographically weighted regression showed that in some African areas the association is negative. The association between conflict events and malaria is positive across the 16 sub-Saharan countries studied, with a particularly strong relationship around Mali and Burkina Faso. At country level, the risk of malaria differed significantly between sub-Saharan countries; the highest malaria prevalence was found in Burkina Faso and the lowest in Rwanda.
Conclusion: Through a global vision of sub-Saharan Africa, this study has identified factors, operating at a number of levels, influencing malaria infection in children. The study has also demonstrated spatial heterogeneity in some of these factors and their influence. This indicates that, when implementing health policies for the eradication of malaria within a country, regional characteristics must be taken into account.
Keywords: Malaria, spatial heterogeneity.
Title: Individual, Household, Community and Country Factors Associated With Malaria in African Children
Author: ELVIRE MFUENI BIKUNDI
International Journal of Social Science and Humanities Research
ISSN 2348-3164 (online), ISSN 2348-3156 (Print)
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